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There are some 50 or more diseases that have heart implications. Some are totally from the genes, such as Alligile Syndrome, others are totally viral or bacterial infection (such as Rheumatic Fever) and are totally happenstance. Other things such as coronary artery disease seem to have genetic links ... if one or both of your parents have had coronary artery disease, then your chances are decidedly higher. Now whether that's because of something actually passed in your genes, or because the diet they ate clogged their arteries and set the ball rolling in your arteries is being studied.
So, from what I can tell, they currently use the generalization that if there's a family history of heart disease, then you are at greater risk.
That said, the risk for coronary artery disease can be almost totally mitigated by diet and lifestyle, which can overwhelm the family history part. So for example, if your parents have coronary artery disease, your own lifestyle and diet can almost eliminate that as a problem for you.
On the other hand there are many genetic defects that you can't do much about, but in these cases, the same rules apply ... with good diet and lifestyle, you can give yourself a better chance of survival in the event you do develop a heart ailment.
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